Children in foster care experience a range of serious developmental, emotional and behavioral problems, but few appropriate early mental health interventions are available to them. The Center for the Vulnerable Child (CVC) at Children's Hospital in Oakland, California provides a model, early mental health intervention that has served over 425 children in foster care. Perinatal drug exposure is involved in over 75% of cases and well over half of children exhibit developmental and mental health problems at intake. Over 75% also have medical problems. The goal of the proposed five-year, longitudinal research project is to improve the mental health and development of very young children in foster care. In conjunction with the Alameda County Social Services Agency, the project will evaluate the effectiveness of the CVC intervention. An experimental design with random assignment to intervention and two control groups will be used, with a sample of 140 in each group. Standard assessment instruments, foster parent satisfaction questionnaires and data collection on services utilization will assess children and foster families at intake and annually for at least two years per family. The project will examine four hypotheses pertaining to program impact on developmental, mental health and foster family functioning, placement changes, and impact of community services utilization. Intervention Group families will receive comprehensive assessments, case management, center-based counseling, foster family support groups and home visit interventions. Data analyses on each hypothesis will employ either linear, co-variate or ordinal logistic regression models comparing intervention and control group outcomes. The effects of several possible intervening variables will be examined. Because this model intervenes with foster families, this study potentially benefits the health and development of large numbers of foster children.